DIFS Online Complaint Forms

Answer the question(s) below to be directed to the complaint form that best suits the issue you are reporting to DIFS. Direct links to each form are located at the bottom of this screen for those that know what form they need.

1. Are you filing this complaint because you received a letter of adverse determination for a health care claim?


2. Are you a company or individual regulated by DIFS filing a concern regarding another company or individual regulated by DIFS?


3. Are you filing a complaint because you have an unresolved dispute with a Pharmacy Benefit Manager?


4. Are you a consumer or a consumer’s representative filing a complaint because you have an unresolved dispute with your insurance and/or financial entity?


Consumer Complaint Form  |  Health Care - Request for External Review (PRIRA)  |  Business to Business Form  |  Fraud Reporting Form  |  Pharmacy Benefit Manager (PBM) Complaint Form